| NPI | 1649536723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CO DR.0061661) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.021051) |
| 207R00000X Internal Medicine (Licence: CO DR.0061661) | |
| 208000000X Pediatrics (Licence: OH 57.021051) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2019-09-19 |